Hi-I am wondering which way to go with considering a subsequent pregnancy. I am obese. I am also age 37. I am wondering whether it would be a better option to wait another year or two while focusing on weight loss to conceive, or to conceive now while obese and be a year or two younger? Which would result in the best outcome? I do have dysmetabolic syndrome, and very mild asthma, however no other serious health issues currently. I am currently well compensated with regard to both medical conditions. I have had two successful healthy pregnancies in the past. Thank you.

As you probably already know obesity can complicate any situation but given your advanced maternal age I would really think it through because as you know you and your baby are at an increased risk for many different things that can happen with one pregnancy that didn't happen with the first. Also it is more difficult to become pregnant when you are obese. You didn't mention if you were obese with the previous pregnancies or if this is something that happened as a result or your pregnancy weight gain. If you decide to try and get pregnant and succeed may I suggest seeing a perinatologist throughout your pregnancy which your OBGYN will most likely suggest you do anyway. The perinatologist can follow you and your baby more closely and I would just feel more comfortable. The answer to the ? as to whether or not you should be younger or thinner is kind of hard to answer but my personal opinion as to whether or not you could and should have another baby safely is that you definitely have a greater chance of having a normal pregnancy seeing how as you don't have any major health problems and if you are indeed going to have another baby I wouldn't wait much longer because lets face it...none of us are getting any younger...haha! I would just suggest that you watch what you eat, exercise regularly and don't gain too much weight. The rest is in God's hands! Best of luck to you and your family and I hope things work out well for you. I hope this helps

Hello,If I were you I would wait a while and work on the weight. Any reduction improves your odds in pregnancy, even if you don't achieve your final weight loss goal.

At your age, another year or two will not significantly alter your risk but losing some weight can have huge benefits. But, if you don't actually work on the weight loss, combining obesity and age over 40 would increase your risks.

So if you are serious about a healthy pregnancy with lowered risk, do something NOW to lose weight. Even lap band surgery can make a huge difference in pregnancy if you can afford it. Outcome of pregnancies following gastric bypass and lap band surgery has been shown to be better than outcomes in obese pregnant women. Nutritional status is important so taking good vitamin supplements after such a procedure is imperative. It is also encouraged that the surgical weight loss patient achieve their goal and level off before becoming pregnant and they are encouraged to wait for a year following the procedure.

Other options can be just as beneficial. Weight Watchers and other guided weight loss plans along with exercise has been shown to be very good prior to pregnancy. You may even wish to see a doctor at a preconception visit to discuss options because there are also medically supervised methods for a more rapid, yet safe, weight loss.

Congratulations on your desire to have a healthy pregnancy. Good luck with it.